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The world needs more physician associates (f.k.a. physician assistants) and more nurse practitioners. The retirement of the Baby Boomer generation has led to a major warp in the demographics of America, creating an aging population that needs a greater amount of medical attention. While the education requirements for medical doctors cause a glut in the pipeline of potential caregivers, the need for the skills of physician associates (PAs) and nurse practitioners (NPs) is growing further. According to the Bureau of Labor Statistics (BLS), both professions are set to grow at a blistering pace that’s around four times the national average for all careers.
To the unitiated, physician associates and nurse practitioners seem to serve a similar role, performing many of the general tasks a doctor would perform: prescribing medication, ordering medical tests, and designing treatment plans. They’re not just nurses and assistants, but they’re not quite medical doctors either. So what are they exactly and what’s the difference between them?
While there’s a lot of overlap between the two positions, think of it like this: physician associates go wide, and nurse practitioners go deep. Physician associates are trained to treat a broad spectrum of patients, while nurse practitioners target a specific population. It starts in school, where physician associates get a broader education in their graduate programs and nurse practitioners go deep into an area of focus. This is also reflected in the certification process, where physician associates take a generalist examination for licensure, while nurse practitioners often pursue advanced population-specific certifications. It’s generally easier to switch specialties as a physician associate because a nurse practitioner will need to undergo more formal training requirements and additional certification steps.
But it’s also not quite that simplistic. The differences between these two roles are more nuanced than a sweeping generalization. Subtle variations exist in educational requirements, prescriptive authority, and licensing requirements. Further variation occurs based on one’s specialty, area of practice, and state of residence. To learn more about the way these professions deviate and overlap, check out our side-by-side comparison chart below.
Side-by-Side Comparison: Physician Associate / Assistant vs Nurse Practitioner
|Physician Associate (PA)||Nurse Practitioner (NP)|
|Education||Physician associates will need a bachelor’s degree, as well as a master’s degree (MPAS, MHS, or MMSc) from a PA school.||In addition to a bachelor’s degree in nursing (BSN), over 99 percent of nurse practitioners have either a master’s degree (MSN) or a doctorate (DNP).|
|Timeline to Practice||In order to practice, a physician associate will typically need a four-year bachelor’s degree, a two-to-three-year master’s degree, and three years of healthcare experience. Allowing for some overlap, the general timeline to practice is between seven to ten years.||In order to practice, a nurse practitioner will typically need a four-year bachelor’s degree and a two-to-four year graduate-level degree. As a general range, the timeline to practice for nurse practitioners is six to eight years.|
|Typical Duties|| While a physician associate’s duties will vary depending on their specialization and location, a general list would include: ||
While a nurse practitioner’s duties
will vary depending upon the regulations in their state, a general
list would include:
|Can Prescribe Medications?||Physician associates are able to prescribe medications in all 50 states, but the specific nature of that prescriptive authority can vary from state to state. As of late 2019, in 47 states, the scope of that prescriptive authority is determined by the supervising physician. Seven states place some regulatory limits on the scope of that authority, particularly regarding the prescription of schedule II and legend substances.||Nurse practitioners are able to prescribe medications, including scheduled substances, in all 50 states. The specific nature of that prescriptive authority, however, can vary. Some states require that nurse practitioners have “collaborative relationships” with a specific supervising physician in order to prescribe medication. Nurse practitioners may also need to undergo a probationary period and register with the DEA.|
|Common Practice Settings||According to the BLS (2019), over 50 percent of physician associates work in physician offices and clinics, just over a quarter work in hospitals, and 8 percent work in outpatient care centers.||According to the American Association of Nurse Practitioners (AANP), over two-thirds of nurse practitioners work in family care, both in outpatient clinics and primary care settings. They can also work in acute care inpatient settings.|
|Licensing and Certification|| Physician associates need to be both state-licensed and certified in order to practice. Certification requires one to pass the 300-question Physician Assistant National Certifying Exam (PANCE), which is administered by the National Commission on Certification of Physician Assistants (NCCPA). Those who pass the exam are eligible to use the Physician Assistant-Certified (PA-C) title. |
For state licensure, each state has its own eligibility requirements. More information can be found on the American Academy of Physician Associates (AAPA) website.
| Nurse practitioners need to be licensed as both a registered nurse (RN) and a nurse practitioner (NP) in their state. Further certifications and their requirements will vary by specialty and location. The most common certifying organizations are: |
|Continuing Education Requirements||In order to maintain their certification and licensure, physician associates are required to complete 100 hours of continuing medical education (CME) every two years. Furthermore, they’ll need to pass the Physician Assistant National Recertification Exam (PANRE) every ten years.||
The quantity and cadence of continuing
nursing education (CNE or CE) required for nurse practitioners
will vary by state and specialty.
Generally speaking, state APRN licenses need to be renewed every one to two years, while specialty certifications are valid for one to five years. The precise amount of CNE required will vary widely. ANCC certifications, for example, are valid for five years, and typically require 75 hours of CNE to renew.
|Specializations|| Physician associates can pursue specialization in many different areas, with some of the most popular being: ||
Nurse practitioners can pursue
specialization in many different areas, including:
|Salary|| According to the BLS (2018), there are 114,710 physician associates currently working in the US, with an average salary is $108,430 per year. To break that down further: || According to the BLS (2018), there are 179,650 nurse practitioners working in the US, with an average salary of $110,030 per year. To break that down further: |
|Career Outlook (2018-2028)||The BLS forecasts that the need for physician associates will grow 31 percent over the next decade, a rate that’s over four times the national average.||The BLS forecasts that the need for nurse practitioners will grow 28 percent in the next decade, a rate that’s nearly four times the national average.|
|Professional Associations and Resources||
Matt is a writer and researcher from Southern California. He’s been living abroad since 2016. Long spells in Eastern Europe, Southeast Asia, and Latin America have made the global mindset a core tenet of his perspective. From conceptual art in Los Angeles, to NGO work on the front lines of Eastern Ukraine, to counterculture protests in the Southern Caucasus, Matt’s writing subjects are all over the map, and so is he.